Premenstrual Syndrome Clinical Trial
Official title:
Short-Term Versus Long-Term Treatment for Severe PMS
Serotonergic antidepressants are clearly effective for premenstrual syndrome (PMS). This study compares short-term treatment (4 months) and long-term treatment (12 months) with sertraline to determine how long medication should be continued after achieving a good response, how soon symptoms return after stopping medication, and whether symptoms are further improved with long-term treatment. Multiple hypotheses include the following: The percent of relapsed subjects is greater with short-term treatment; relapse is swifter with short-term treatment; relapsed subjects improve swiftly when returned to medication; patient satisfactions and quality of life are more improved with long-term treatment.
Severe PMS is a chronic and complex mood disorder that involves mood, behavioral and
physical symptoms linked to the menstrual cycle with severity that disrupts functioning for
as much as several weeks each menstrual cycle. Estimates indicate that 20-25% of
menstruating women experience severe PMS. The efficacy of serotonergic antidepressants is
clearly demonstrated for severe forms of PMS in short-term treatment trials. This study
compares short-term treatment (4 months) and long-term treatment (12 months) with sertraline
in a randomized, placebo-controlled design. The purpose is to determine how long medication
should be continued following symptom relief, to what extent and how rapidly symptoms return
after stopping medication, and whether there is any additional improvement with long-term
treatment.
Following a screen period for 2-3 menstrual cycles that includes a placebo-treated cycle,
eligible women are randomized double-blind to the short-term or long-term treatment arm.
Subjects are switched (double-blind) to placebo after 4 months or 12 months of sertraline
treatment. All subjects continue the study for a total of 21 months and receive either
sertraline or the matching placebo in this interval. Subjects whose symptoms return are
given open-label sertraline without breaking the study blind. Subjects rate symptoms daily
throughout the study using the Penn Daily Symptom Report. Other assessments are conducted at
monthly intervals and include the Clinical Global Impressions Rating Scale, Sheehan
Disability Scale, Hamilton Depression Rating Scale, Endicott Quality of Life Questionnaire
and the Cohen Perceived Stress Scale. The overall duration of the study is expected to be
5-6 years.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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